Pilot Investigation of Behavioral Alternatives to Indoor Tanning

描述（由申请人提供）：35岁之前的室内晒黑（IT）会增加患黑色素瘤的风险，黑色素瘤是最致命的皮肤癌。尽管存在风险，但25-40%的年轻女性报告在过去一年中使用过。室内装饰师报告了IT的两个原因：物理外观和减轻压力。行为经济学理论表明，减少不健康行为的有效方法是增加替代品，这些替代品以可比或更少的努力或成本提供类似功能。除非晒黑（ST）是一个很有前途的IT替代品，因为它产生晒黑没有紫外线暴露。越来越多的证据表明，采用ST的室内游泳者随后会减少IT。9我们对海滩游客的试验显示，ST干预后日光浴减少，但我们尚未在室内游泳者中进行测试，对他们来说，晒黑的愿望是一个强大的动力（比海滩游客更强）。1 ST的一个挑战是它不是减轻压力的来源，这是年轻女性在室内晒黑的另一个主要原因。瑜伽是有效的减压，所以可能有潜力成为一个健康的替代IT。一起ST和瑜伽，通过解决两个关键的IT动机，可能证明是一个有效的组合，减少IT. The本研究的目的是确定的可行性和短期疗效提供免费的ST和瑜伽，室内taglies在努力“轻推”他们从IT切换到健康的替代品。选择健康的替代品（ST和瑜伽）是基于它们具有与IT相似的直接后果，而两者都不可能在IT期间进行（以避免增强）。免费获得健康的替代品为参与者提供了一个低风险的机会，可以尝试与他们的动机一致的新事物。体验替代品的强化特性可以推动继续使用。我们将开始进行女性室内瑜伽的焦点小组，以征求意见和障碍ST和哈达瑜伽和反馈建议的干预程序。在完善干预措施后，女性室内运动员（N=150）将被随机分配到三种条件之一：无叶晒黑，无叶+瑜伽和对照。我们假设，与对照组相比，无叶状态将导致IT的更大降低，而无叶+瑜伽将导致IT的更大降低。将评估健康替代品相对于I的成本、收益和可接受性。将测试干预措施对IT影响的调节剂（晒黑依赖性，感觉寻求，身体形象，感知压力）和调解剂（瑜伽的减压效果，ST和瑜伽的可接受性）。干预后将进行焦点小组，以评估干预的可接受性、促进因素和障碍。我们还将对制革企业主进行关键的知情人访谈，以评估他们对什么类型的数据和/或新立法将迫使他们改变商业计划以实现健康替代品的反应和意见。本研究的数据将用于支持一项更大规模的试验，该试验测试了相对于有效的基于打印的干预措施，有无瑜伽的ST免费试用期的短期和长期影响。 公共卫生相关性：紫外线辐射暴露会增加患黑色素瘤的风险，特别是在室内晒黑的年轻女性中。室内晒黑者报告说，他们晒黑是为了改善他们的外表和减轻压力，这些好处似乎超过了健康风险。目前的研究将确定是否激励室内晒黑者参与健康的替代行为，提高外观（无阳光晒黑）和减少压力（瑜伽）将减少他们的室内晒黑。

DESCRIPTION (provided by applicant): Indoor tanning (IT) before the age of 35 increases risk for melanoma-the most fatal type of skin cancer. In spite of the risks, 25-40% of young women report use in the past year. Indoor tanners report two reasons for IT: physical appearance and stress reduction. Behavioral economic theory suggests that an effective way to decrease an unhealthy behavior is by increasing alternatives that serve a similar function with comparable or less effort or cost. Sunless tanning (ST) is a promising IT alternative because it produces a tan without UVR exposure. Mounting evidence suggests that indoor tanners who adopt ST subsequently reduce IT.9 Our trial of beach visitors showed reduced sunbathing following a ST intervention, but we have not tested this in indoor tanners, for whom the desire to be tan is a strong motivator (more so than beach visitors).1 One challenge to ST is that it is not a source of stress reduction, the other major reason young women tan indoors. Yoga is efficacious for stress reduction and so may have potential to be a healthy alternative to IT. Together ST and yoga, by addressing both key IT motivators, may prove a potent combination for reducing IT. The objective of the present study is to determine the feasibility and short-term efficacy of providing free ST and yoga to indoor tanners in an effort to "nudge" them to switch from IT to healthy alternatives. The healthy alternatives (ST and yoga) were chosen based on their having similar immediate consequences as IT, while both being impossible to do during IT (to avoid potentiation). Free access to healthy alternatives gives participants a low-risk opportunity to try something new that is consistent with their motivations. Experiencing the reinforcing properties of the alternatives could prime continued use. We will begin by conducting focus groups of female indoor tanners to solicit opinions about and barriers to ST and Hatha yoga and feedback on proposed intervention procedures. After refining the intervention, female indoor tanners (N=150) will be randomized to one of three conditions: Sunless Tanning, Sunless+Yoga, and Control. We hypothesize that the Sunless condition will lead to greater reductions in IT relative to Control, and Sunless+Yoga will lead to greater reductions in IT relative to Sunless alone. Costs, benefits, and acceptability of healthy alternatives relative to I will be assessed. Moderators (tanning dependency, sensation seeking, body image, perceived stress) and mediators (stress reduction effect of yoga, acceptability of ST and yoga) of the interventions effects on IT will be tested. Focus groups will be conducted following the intervention to evaluate acceptability, facilitators, and barriers to the interventions. We will alo conduct key informant interviews of tanning business owners to assess their reactions and opinions on what type of data and/or new legislation would compel them to change their business plan toward healthy alternatives. Data from the present study will be used to support a larger trial that tests the short- and long-term effects of free trial periods of ST with and withot yoga relative to an effective print-based intervention. PUBLIC HEALTH RELEVANCE: Ultraviolet radiation exposure heightens risk for melanoma, especially among young women who tan indoors. Indoor tanners report that they tan to improve their physical appearance and to reduce stress, and these benefits seem to outweigh the health risks. The present study will determine whether incentivizing indoor tanners' engagement in healthy alternative behaviors that enhance appearance (sunless tanning) and reduce stress (yoga) will decrease their indoor tanning.